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Response To Sudden Load By Patients With Back Pain - Introduction; Proceedings Of The First American Conference On Human Vibration
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6/1/2006
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Description:As mechanical shock and vibration environments evolve, it is important to understand their potential effect on human operators. Human beings are sophisticated mechanisms comprised not only of passive components with mass, damping, and stiffness characteristics, but also of components that can actively affect apparent mass, stiffness, and damping. Because the lumbar spine can exhibit local, short-column buckling, stability of the human trunk depends on the responsiveness of the neuromuscular control system.1-2 We have been evaluating the ability of patients with back pain to respond to a series of sudden loads. We believe the results have implications for isolation design and standards development. Methods 153 patients, aged 21 to 55, presenting with back pain agreed to enroll in a research study that randomly assigned them to one of three treatment arms: high velocity low amplitude spinal manipulation, low velocity variable amplitude spinal manipulation, or wait for 2 weeks and then be randomized to one of the above groups. Response to sudden load testing was one of a battery of baseline evaluations performed upon entry into the study and prior to treatment. EMG electrodes were attached to the skin over the paraspinal muscles of the standing participant bilaterally 3 cm from midline at the L3 level. While standing upright on a force plate (Bertec), participants were fitted with a strap around their back and hooked to a load cell in front of their chest. An accelerometer was rigidly attached to the load cell. Impact was applied to the chest using a cord attached to a falling weight. The weight’s fall distance was varied between 9 and 13 inches to account for the size of the subject. The subject was blindfolded and wore headphones playing white noise to prevent cueing of when the weight was dropped to apply the load. Hence, although the participant knew a load was about to be applied, he or she did not know the instant it would occur. Just before the weight was dropped, a 4 second data collection process was started for the two EMG electrodes, load cell, accelerometer, and force plate. The load drop was repeated 6 times, at irregular intervals, over a period of 2 minutes. The raw data thus collected was reduced to obtain several values: 1) length of time from the pull on the harness to the beginning of the response of the left and right paraspinal muscles (LES, RES), 2) time and magnitude of the maximum response, 3) force and acceleration experienced at the chest, and 4) the time and magnitude of the center of pressure location (COP). A general linear model was used to evaluate the results. Results For the EMG data, of the 1,824 observations made, 90% of them indicated a response. Prior to the sudden load, resting muscle activity was different between left and right sides (p=0.0001) and between males and females (p=0.0001). Female subjects began to respond to the sudden load within 92 to 110 ms and males from 101 to 109 ms. Females exhibited more variation in starting
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